Arthritis Watch

Published Online: Wednesday, April 1, 2009

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Is Depression Associated with RA?

Disability and a recent diagnosis of rheumatoid arthritis (RA)
are linked with a greater risk for depression, according to
study findings recently presented at the American College of
Rheumatology Annual Scientific Meeting.

Study results indicated that patients with RA who are
depressed have worse outcomes than patients with RA who
are not depressed. Earlier studies regarding RA and depression
included a primarily Caucasian population.

To eliminate this bias, researchers from the University of
California, San Francisco, created a study to evaluate predictors
of depression in patients from a multiethnic group of
individuals with RA at an urban hospital.

Of the 210 patients enrolled in the study, 39% had scores
on the Patient Health Questionnaire-9 that indicated at least
moderate depression. Patient, disease, and treatment-related
information were collected to see if any of these factors
were associated with depression.

The study results found that race/ethnicity, disease activity,
and medications were not associated with depression. The
factors related to depression are shorter disease duration
and increased disability as scored on the Health Assessment
Questionnaire.

Working Splints Reduce Wrist Arthritis Pain

Patients with wrist arthritis benefit from working splints,
according to Dutch researchers, whose study was published
in the December 2008 issue of Arthritis & Rheumatism.

For the study, the researchers assessed the effectiveness of
wrist splinting that allowed enough movement to perform regular
activities in 33 patients with wrist arthritis. Of the patients, 17
were assigned to use a prefabricated wrist working splint and 16
acted as the control group. The patients in the splinting group
were told to use the splint as much as possible during the day.

After 4 weeks, the investigators found a 32% decrease in
pain scores registered on a visual analog scale in the treatment
group, whereas the scores in the control group increased by
17%. Furthermore, the average grip strength scores rose by 5%
in the splinting group and dropped by 8% in the control group.
The researchers noted, however, that these and other differences
in functional ability were not major, statistically speaking.

Teens with Arthritis Need More Counseling

Results of a study, reported in the January 2009 issue of
Arthritis Care & Research, showed that children with arthritis
need more assistance and information during their teen years
to make sure they receive proper health care as adults.

The researchers looked at data from the 2005-2006 National
Survey of Children with Special Health Care Needs. Four
questions examined the extent to which providers discussed
health care transition issues, including transfer of care to
adult providers, health care needs of adults, acquiring health
insurance, and encouraging self-care responsibility.

Whereas 75% of adolescents with arthritis are being
encouraged to assume self-care responsibilities, only about
20% of adolescents with arthritis were given counseling on
issues such as obtaining health insurance after coming of age,
study results showed.

The findings mirrored similar national studies of young
people with any special health care needs. “Health care transition
is a complex set of tasks that are embedded within a
complex developmental period and a complex health care
system,” the researchers wrote.

Abnormal ECG Detected in PsA Patients

The findings from a new study advise that patients with psoriatic
arthritis (PsA) may have “subtle” cardiac conduction disturbances.
The researchers noted, however, that it has not yet been
determined if these irregularities lead to serious heart disease.

PsA is a form of rheumatoid arthritis accompanied by psoriasis.
In the study, the researchers compared the electrocardiogram
(ECG) scans of 92 patients with PsA with 92 control
patients, individually matched for age and sex, who did not
have the condition.

“The major finding of our study,” reported the researchers
in the Journal of Rheumatology (December 2008), “is a
statistically significantly longer PR interval in the patients with
PsA, compared with individuals without psoriasis or arthritis.”
The lengthening of the PR interval is a sign of abnormal heart
rhythm. The average PR interval was 8.3 milliseconds, 5.5%
longer in the PsA patients, compared with the controls.

“Although the clinical relevance of this finding is questionable
since the absolute difference was small, the importance
of the observation is the implication of atrioventricular node
involvement in the psoriatic arthritis systemic diseases,” noted
the researchers.

The researchers concluded that a larger study with a follow-up
period is necessary to further investigate these conduction abnormalities
and to see if they are related to cardiovascular disease.

F A S T F A C T: One in 5 (21%) adults in the United States report having doctor-diagnosed arthritis.